28/10/2026
𝐓𝐇𝐄 𝐈𝐌𝐏𝐎𝐑𝐓𝐀𝐍𝐂𝐄 𝐎𝐅 𝐂𝐋𝐈𝐍𝐈𝐂𝐀𝐋 𝐃𝐈𝐀𝐆𝐍𝐎𝐒𝐈𝐒 𝐈𝐍 𝐋𝐎𝐖-𝐑𝐄𝐒𝐎𝐔𝐑𝐂𝐄 𝐒𝐄𝐓𝐓𝐈𝐍𝐆𝐒.
As a genuine doctor working in a low-resource setting, you have no option but to develop strong clinical diagnostic skills. There will be many times when you find yourself working in a health centre or hospital where some basic diagnostic investigations are either unavailable or non-functional. At such critical moments, you must rely on your clinical knowledge and skills to establish a working diagnosis and determine the appropriate management plan.
Medical schools in 𝐒𝐨𝐮𝐭𝐡 𝐒𝐮𝐝𝐚𝐧 should structure their curricula to equip students with strong clinical diagnostic skills. To achieve this, students should be exposed to clinical scenarios as early as the preclinical years through 𝗣𝗿𝗼𝗯𝗹𝗲𝗺-𝗕𝗮𝘀𝗲𝗱 𝗟𝗲𝗮𝗿𝗻𝗶𝗻𝗴 (𝗣𝗕𝗟), a student-centred teaching method in which medical students learn by working through clinical cases or problems rather than relying solely on lectures.
𝗙𝗼𝗿 𝗲𝘅𝗮𝗺𝗽𝗹𝗲, 𝗮 𝘁𝘂𝘁𝗼𝗿 𝗽𝗿𝗲𝘀𝗲𝗻𝘁𝘀 𝘁𝗵𝗲 𝗳𝗼𝗹𝗹𝗼𝘄𝗶𝗻𝗴 𝗰𝗮𝘀𝗲:
A 45-year-old man presents with fever, cough, night sweats, and weight loss lasting three weeks.
𝗦𝘁𝘂𝗱𝗲𝗻𝘁𝘀 𝘄𝗼𝗿𝗸 𝗶𝗻 𝘀𝗺𝗮𝗹𝗹 𝗴𝗿𝗼𝘂𝗽𝘀 𝘁𝗼:
1• 𝐈𝐝𝐞𝐧𝐭𝐢𝐟𝐲 𝐭𝐡𝐞 𝐩𝐫𝐨𝐛𝐥𝐞𝐦𝐬: List the patient's symptoms and clinical findings.
2• 𝐆𝐞𝐧𝐞𝐫𝐚𝐭𝐞 𝐡𝐲𝐩𝐨𝐭𝐡𝐞𝐬𝐞𝐬: Consider possible diagnoses, such as pulmonary tuberculosis, pneumonia, or lung cancer.
3• 𝐈𝐝𝐞𝐧𝐭𝐢𝐟𝐲 𝐥𝐞𝐚𝐫𝐧𝐢𝐧𝐠 𝐨𝐛𝐣𝐞𝐜𝐭𝐢𝐯𝐞𝐬: Determine what they need to study, including the causes, pathophysiology, investigations, and management of the suspected conditions.
4• 𝐂𝐨𝐧𝐝𝐮𝐜𝐭 𝐬𝐞𝐥𝐟-𝐝𝐢𝐫𝐞𝐜𝐭𝐞𝐝 𝐥𝐞𝐚𝐫𝐧𝐢𝐧𝐠: Study independently using textbooks, clinical guidelines, and other reliable resources.
5• 𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐚𝐧𝐝 𝐚𝐩𝐩𝐥𝐲 𝐭𝐡𝐞𝐢𝐫 𝐤𝐧𝐨𝐰𝐥𝐞𝐝𝐠𝐞: Reconvene to share their findings, evaluate their hypotheses, and develop a diagnostic and management plan.
When students progress to their clinical years, they should undergo 𝗽𝗮𝘁𝗶𝗲𝗻𝘁-𝗯𝗮𝘀𝗲𝗱 𝗹𝗲𝗮𝗿𝗻𝗶𝗻𝗴 𝘂𝗻𝗱𝗲𝗿 𝘁𝗵𝗲 𝘀𝘂𝗽𝗲𝗿𝘃𝗶𝘀𝗶𝗼𝗻 𝗼𝗳 𝗲𝘅𝗽𝗲𝗿𝗶𝗲𝗻𝗰𝗲𝗱 𝗽𝗵𝘆𝘀𝗶𝗰𝗶𝗮𝗻𝘀. Senior physicians should teach them how to obtain a comprehensive patient history, conduct meticulous physical examinations, formulate appropriate differential diagnoses, request essential laboratory and diagnostic investigations where available, and develop suitable management plans.
These learning activities should take place at the patient's bedside, during ward rounds, and through bedside teaching and clinical discussion sessions.
We encourage medical students and practising doctors in South Sudan to embrace this approach. By strengthening clinical reasoning and diagnostic skills from the earliest stages of medical training, we can better prepare our doctors to work effectively in local health centres and hospitals, where they may sometimes have little more than their clinical knowledge and judgement to guide them in saving lives.
a Genuine Doctor.👨⚕️👩⚕️🩺💊💉
